Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19) – anatomic pathology perspective on current knowledge

Abstract

Background: The world is currently witnessing a major devastating pandemic of Coronavirus disease-2019 (COVID-19). This disease is caused by a novel coronavirus named Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). It primarily affects the respiratory tract and particularly the lungs. The virus enters the cell by attaching its spike-like surface projections to the angiotensin-converting enzyme-2 (ACE-2) expressed in various tissues. Though the majority of symptomatic patients have mild flu-like symptoms, a significant minority develop severe lung injury with acute respiratory distress syndrome (ARDS), leading to considerable morbidity and mortality. Elderly patients with previous cardiovascular comorbidities are particularly susceptible to severe clinical manifestations. Body: Currently, our limited knowledge of the pathologic findings is based on post-mortem biopsies, a few limited autopsies, and very few complete autopsies. From these reports, we know that the virus can be found in various organs but the most striking tissue damage involves the lungs resulting almost always in diffuse alveolar damage with interstitial edema, capillary congestion, and occasional interstitial lymphocytosis, causing hypoxia, multiorgan failure, and death. A few pathology studies have also reported intravascular microthrombi and pulmonary thrombembolism. Although the clinical presentation of this disease is fairly well characterized, knowledge of the pathologic aspects remains comparatively limited. Conclusion: In this review, we discuss clinical, pathologic, and genomic features of COVID-19, review current hypotheses regarding the pathogenesis, and briefly discuss the clinical characteristics. We also compare the salient features of COVID-19 with other coronavirus-related illnesses that have posed significant public health issues in the past, including SARS and the Middle East Respiratory Syndrome (MERS).

The Immunopathological and Histological Landscape of COVID-19-Mediated Lung Injury

“…Many histopathological findings have been identified in autoptic specimens [ 10 ]. Nevertheless, it is important to notice that none of the described histological features is pathognomonic or highly specific [ 11 ], and future gene expression profiling studies should be performed on these specimens.…”

Stages of COVID-19 pandemic and paths to herd immunity by vaccination: dynamical model comparing Austria, Luxembourg and Sweden

“…This can be clearly seen from Fig. S1, panel C, which shows data for daily new detected cases, people entering hospital and people entering ICU (not to be confused with the number of people currently occupying hospitals and ICUs) publicly available on [27] and 1 . It becomes obvious that in March and April the daily number of people entering hospital was more than half of the daily number of detected cases, leading us to employ a time-dependent p 2Swe (t).…”

“…2, we simulate the potential evolution of the epidemic in the coming months until spring. After the last data-point, we simulate three scenarios, to illustrate alternative potential outcomes, namely one corresponding to no change in social interaction, an optimistic scenario where the social interaction parameter becomes as low as during the lockdown 1 https://www.icuregswe.org/en/data--results/COVID-19-in-swedish-intensive-care/…”

Les lésions histologiques pulmonaires associées à l’infection par le Sars-CoV-2

“…Les images initialement décrites pour une grande majorité de patients correspondent à des lésions de dommage alvéolaire diffus (DAD) et à des lésions vasculaires [ 9 , 10 ]. Il existe ainsi souvent des exsudats cellulaires fibro-myxoïdes, une desquamation des pneumocytes, des membranes hyalines, et des images habituellement notées dans les phases précoces du syndrome aiguë de détresse respiratoire ( figure 1 ) [ [11] , [12] - 13 ]. En fait, les lésions de DAD ainsi observées sont identiques à celles décrites dans d’autres circonstances ou pathologies induisant de telles lésions [ 14 ].…”